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1.
Four MRI variables have recently been suggested to be independently associated with a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion. Midline intervertebral disk herniation, and partial intervertebral disk degeneration were associated with intervertebral disk protrusion, while presence of a single intervertebral disk herniation and disk material dispersed beyond the boundaries of the intervertebral disk space were associated with intervertebral disk extrusion. The aim of this retrospective, cross‐sectional study was to determine whether using these MRI variables improves differentiation between thoracolumbar intervertebral disk extrusions and protrusions. Eighty large breed dogs with surgically confirmed thoracolumbar intervertebral disk extrusions or protrusions were included. Randomized MRI studies were presented on two occasions to six blinded observers, which were divided into three experience categories. During the first assessment, observers made a presumptive diagnosis of thoracolumbar intervertebral disk extrusion or protrusion without guidelines. During the second assessment they were asked to make a presumptive diagnosis with the aid of guidelines. Agreement was evaluated by Kappa‐statistics. Diagnostic accuracy significantly improved from 70.8 to 79.6% and interobserver agreement for making a diagnosis of intervertebral disk extrusion or intervertebral disk protrusion improved from fair (κ = 0.27) to moderate (κ = 0.41) after using the proposed guidelines. Diagnostic accuracy was significantly influenced by degree of observer experience. Intraobserver agreement for the assessed variables ranged from fair to excellent and interobserver agreement ranged from fair to moderate. The results of this study suggest that the proposed imaging guidelines can aid in differentiating thoracolumbar intervertebral disk extrusions from protrusions.  相似文献   

2.
Treatment recommendations differ for dogs with intervertebral disk extrusion vs. intervertebral disk protrusion. The aim of this retrospective, cross‐sectional study was to determine whether clinical and magnetic resonance imaging (MRI) variables could be used to predict a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion in dogs. Dogs were included if they were large breed dogs, had an MRI study of the thoracolumbar or lumbar vertebral column, had undergone spinal surgery, and had the type of intervertebral disk herniation (intervertebral disk extrusion or protrusion) clearly stated in surgical reports. A veterinary neurologist unaware of surgical findings reviewed MRI studies and recorded number, location, degree of degeneration and morphology of intervertebral disks, presence of nuclear clefts, disk space narrowing, extent, localization and lateralization of herniated disk material, degree of spinal cord compression, intraparenchymal intensity changes, spondylosis deformans, spinal cord swelling, spinal cord atrophy, vertebral endplate changes, and presence of extradural hemorrhage. Ninety‐five dogs were included in the sample. Multivariable statistical models indicated that longer duration of clinical signs (P = 0.01), midline instead of lateralized disk herniation (P = 0.007), and partial instead of complete disk degeneration (P = 0.01) were associated with a diagnosis of intervertebral disk protrusion. The presence of a single intervertebral herniation (P = 0.023) and dispersed intervertebral disk material not confined to the disk space (P = 0.06) made a diagnosis of intervertebral disk extrusion more likely. Findings from this study identified one clinical and four MRI variables that could potentially facilitate differentiating intervertebral disk extrusions from protrusions in dogs.  相似文献   

3.
OBJECTIVE: To determine magnetic resonance imaging (MRI) abnormalities in dogs with intervertebral disk disease (IVDD) and develop a classification scheme for IVDD in dogs based on MRI findings. DESIGN: Retrospective case series. ANIMALS: 69 dogs. PROCEDURE: Medical records of dogs admitted because of thoracolumbar IVDD in which MRI of T9 through L7 had been performed were reviewed. RESULTS: A total of 759 intervertebral disk spaces were examined. Of these, 342 (45.1%) were classified as having a normal MRI appearance; the remaining 417 (54.9%) had various types of IVDD. Disk degeneration was identified in 276 disk spaces in 56 dogs, bulging of the intervertebral disk was identified in 37 disk spaces in 24 dogs, disk protrusion was identified in 54 disk spaces in 32 dogs, and disk extrusion was identified in 50 disk spaces in 48 dogs. Cartilage endplate changes were identified in 35 vertebrae in 17 dogs, and increased signal intensity of the spinal cord was identified in 21 dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Four types of IVDD (disk degeneration, bulging of the intervertebral disk, disk protrusion, and disk extrusion) were identified on the basis of MRI findings in dogs with thoracolumbar IVDD. We recommend that a standardized nomenclature be adopted for the various types of thoracolumbar IVDD in dogs.  相似文献   

4.
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5.
Myelography and/or computed tomography (CT) are commonly used to evaluate acute intervertebral disk extrusion in chondrodystrophic dogs. The purpose of this study was to evaluate the sensitivity of myelography and two different CT protocols in determining level and lateralization of acute thoracolumbar intervertebral disk extrusion in comparison with surgical findings, investigate interobserver variability, and determine examination duration times. Results of conventional CT, helical CT, and myelography were compared with surgical findings in 19 chondrodystrophic dogs with acute thoracolumbar intervertebral disk extrusion. Agreement among investigators was determined for different imaging modalities, and examination times were recorded. In the diagnosis of level of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 94.7%, 100%, and 94.7% of dogs, respectively ( P =0.144). In the diagnosis of level and lateralization of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 78.9%, 87.4%, and 85.3% of dogs, respectively ( P =0.328). Interobserver agreement was very good for all imaging modalities (myelography κ=0.87; conventional CT κ=0.86; helical CT κ=0.95). There were significant differences in median examination duration times between helical CT (4 min), conventional CT (8 min), and myelography (32 min) ( P <0.001). Both helical and conventional CT appear to be accurate for evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs and are faster to perform than myelography.  相似文献   

6.
Intervertebral disk space widths were measured on lateral radiographs of 73 anesthetized dogs. Weight was found to have a significant (P less than 0.01) effect on disk space width. Using weight-adjusted disk space width measurements for all subsequent studies, older (7- to 16-year-old) dogs and males had consistently, but not significantly, wider, disk spaces than did alternative groups. Cervical and lumbar intervertebral disk spaces tended to be wider than those in the caudal thoracic region. The widest cervical intervertebral disk spaces were C4-5 and C5-6 and the narrowest was C2-3. In the lumbar region, L2-3 was the widest disk space and L4-5 was the narrowest. Dachshunds generally had greater mean intervertebral disk space width than did other breeds of dogs. Cervical (n = 6 dogs) and thoracolumbar (n = 6 dogs) disk fenestration resulted in narrow intervertebral disk spaces, regardless of breed. When a ventral approach was used in thoracolumbar fenestration, the mean intervertebral disk space was narrower than that resulting from use of a dorsolateral approach. Spondylosis was found radiographically 1 to 4 years after intervertebral disk fenestration in 3 of 6 dogs that had cervical fenestrations and in 5 of 6 dogs that underwent thoracolumbar fenestration.  相似文献   

7.
Magnetic resonance imaging (MRI) and computed tomography (CT) are commonly used to evaluate dogs with thoracolumbar myelopathy; however, relative diagnostic sensitivities for these two modalities have not been previously reported. The purpose of this prospective study was to compare diagnostic sensitivity and observer agreement for MRI and CT in a group of dogs with thoracolumbar myelopathy due to surgically confirmed intervertebral disk herniation (IVDH). All included dogs had magnetic resonance (MR) imaging followed by noncontrast CT using standardized protocols. Three experienced observers interpreted each imaging study independently without knowledge of clinical or surgical findings. The operating surgeon was aware of MR findings but not CT findings at the time surgical findings were recorded. Forty‐four dogs met the inclusion criteria. The sensitivity of CT was 88.6% (79.5%–94.2%) and of MR was 98.5% (95% confidence interval, 94.1%–99.7%) for diagnosis of intervertebral disk herniation. Specificity was not calculated, as all dogs had IVDH at surgery. Magnetic resonance imaging was more accurate than CT for identifying the site of intervertebral disk herniation‐associated spinal cord compression and differentiating disk extrusion vs. protrusion. Computed tomography was less accurate for lesion localization in per acute cases, as well as for chondrodystrophic, female, older and smaller (<7 kg) dogs. Inter‐rater agreement was good for lesion lateralization for both MR and CT (κ = 0.687, 95% CI = 0.552, 0.822, P = 0.002, and κ = 0.692, 95% CI = 0.542, 0.842, P = 0.003). Findings from the current study indicated that MR imaging was more sensitive and accurate than noncontrast CT for diagnosis and characterization of thoracolumbar myelopathy due to IVDH in dogs.  相似文献   

8.
Sixty-four dogs with histories and clinical signs consistent with cervical intervertebral disk disease were presented for evaluation. Survey spinal radiographs were obtained, followed by myelography. In 61% of the survey radiographs, evaluators identified sites of disk extrusion or protrusion based on radiographic findings. Of those radiographs where a site was identified, ability to accurately identify the correct site of disk extrusion ranged from 53% to 67%, with an average of 58%. Therefore, the overall accuracy rate for correct identification of the site(s) of disk extrusion for all survey radiographs was 35%. Twelve cases had more than one site of disk extrusion or protrusion evident myelographically. In cases where multiple sites of extrusion were confirmed myelographically, the ability to localize at least one of the sites on the corresponding survey radiographs ranged from 63% to 80%, with an average of 70%. The major site of disk extrusion or protrusion was incorrectly identified in 16% to 31% of the survey radiographs, with an average of 26%. The use of survey radiographs alone is an inaccurate means for localization of cervical intervertebral disk extrusion or protrusion.  相似文献   

9.
Objective— To describe the influence of fenestration at the disc herniation site on recurrence in thoracolumbar disc disease of chondrodystrophoid dogs.
Study Design— Prospective clinical study.
Animals— Chondrodystrophic dogs (n=19).
Methods— Dogs were divided into 2 groups: group 1 (9 dogs) had thoracolumbar disc extrusion (Hansen type I) treated by hemilaminectomy and concomitant fenestration of the affected intervertebral disc and group 2 (10 dogs) had hemilaminectomy without fenestration. All dogs had 3 magnetic resonance imaging (MRI) examinations: preoperatively, immediately postoperatively to assess removal of herniated disc material, and again 6 weeks after surgery.
Results— There were 13 male and 6 female dogs; mean age, 7.1 years. Thoracolumbar disc herniation was confirmed with MRI. Immediate post surgical MRI revealed that the herniated disc removal was complete in all but 1 dog and that fenestration did not lead to complete removal of nucleus pulposus within the intervertebral disc space. On the 3rd MRI examination, none of the group 1 dogs had further disc material herniation at the fenestrated site. Six of the 10 group 2 dogs had a recurrence of herniation leading to clinical signs in 3 dogs (pain in 2 dogs, paresis in 1 dog).
Conclusion— In thoracolumbar disc herniation, fenestration of the affected intervertebral disc space prevents further extrusion of disc material.
Clinical Relevance— Fenestration reduces the risk of early recurrence of disc herniation and associated postoperative complications.  相似文献   

10.
Objective – To compare the incidence of seizures in dogs with intervertebral disk disease after iopamidol or iomeprol myelography, and to assess whether the incidence of seizures differed between the 2 agents when severity of neurological deficits, location of cord compression, duration of anesthesia, site of myelogram, volume of contrast, and concentration of contrast were evaluated. Design – Retrospective study. Setting – Veterinary teaching hospital. Animals – One hundred and sixty‐one client‐owned dogs with intervertebral disk disease. Interventions – Subarachnoid injection of contrast medium. Measurements and Main Results – One hundred and sixty‐one dogs with intervertebral disk disease were subjected to myelography using iopamidol (n=74) or iomeprol (n=87). Cranial myelography was performed in 31 dogs, caudal myelography in 125 and both cranial and caudal myelography in 5. Seizures occurred in 23 of 161 (14%) dogs. There was no significant difference overall between iopamidol and iomeprol myelography. However, in dogs with thoracolumbar disk extrusion and paraplegia, seizures occurred more frequently after caudal myelography using iopamidol compared with iomeprol. Conclusions – Both iomeprol and iopamidol are suitable for myelography in dogs. Iomeprol is recommended for caudal myelography in paraplegic dogs with thoracolumbar disk extrusion due to the higher incidence of seizures in this group when iopamidol was used.  相似文献   

11.
OBJECTIVE: To determine complications and neurologic outcomes associated with dexamethasone administration to dogs with surgically treated thoracolumbar intervertebral disk herniation, compared with dogs not receiving dexamethasone. DESIGN: Retrospective case series. ANIMALS: 161 dogs with surgically confirmed thoracolumbar disk herniation. PROCEDURES: Medical records from 2 hospitals were used to identify dogs that had received dexamethasone < 48 hours prior to admission (dexamethasone group dogs), dogs that received glucocorticoids other than dexamethasone < 48 hours prior to admission (other-glucocorticoid group dogs), and dogs that received no glucocorticoids (nontreatment group dogs). Signalment, neurologic injury grade, laboratory data, and complications were extracted from medical records. RESULTS: Dexamethasone group dogs were 3.4 times as likely to have a complication, compared with other-glucocorticoid or nontreatment group dogs. Dexamethasone group dogs were 11.4 times as likely to have a urinary tract infection and 3.5 times as likely to have diarrhea, compared with other-glucocorticoid or nontreatment group dogs. No differences in neurologic function at discharge or recheck evaluation were detected among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that treatment with dexamethasone before surgery is associated with more adverse effects, compared with treatment with glucocorticoids other than dexamethasone or no treatment with glucocorticoids, in dogs with thoracolumbar intervertebral disk herniation. In this study population, no difference in outcome was found among groups. These findings suggest that the value of dexamethasone administration before surgery in dogs with thoracolumbar disk herniation should be reconsidered.  相似文献   

12.
To assess the diagnostic accuracy of survey radiography for canine thoracolumbar intervertebral disc protrusion, survey radiographs (lateral and ventrodorsal) of 64 dogs with surgically-confirmed thoracolumbar intervertebral disc protrusion, 51 dogs with negative myelograms and 29 dogs with various spinal conditions other than disc protrusion were reviewed by three independent observers who were unaware of any clinical information. There were marked differences in observer performance for diagnosis of intervertebral disc protrusion, although there were no significant differences in intraobserver diagnostic accuracy for small vs. large dogs. Accuracy of observers for determining sites of intervertebral disc protrusion using survey radiography was in the range 51-61%. All observers had low accuracy for identification of second sites of intervertebral disc protrusion. The most useful radiographic sign, narrowed intervertebral space, had only moderate sensitivity (range 64-69%) and moderate predictive value (range 63-71%) for intervertebral disc protrusion. Vacuum phenomenon was an infrequent but accurate sign of intervertebral disc protrusion. Recognition of multiple radiographic signs of intervertebral disc protrusion at one site was associated with increased accuracy of diagnosis. No observer was accurate enough to justify attempting targeted surgical treatment of intervertebral disc protrusion without myelography.  相似文献   

13.
OBJECTIVE: To determine whether magnetic resonance imaging findings in dogs with paraplegia caused by thoracolumbar intervertebral disk extrusion were predictive of clinical outcome. DESIGN: Retrospective case series. ANIMALS: 77 dogs. PROCEDURE: Medical records and magnetic resonance images were reviewed; clinical outcome was classified as successful (regained ability to walk with no more than mild neurologic deficits) or unsuccessful (severe neurologic deficits persisted). The prognostic value of magnetic resonance imaging was compared with prognostic value of deep pain perception, duration of clinical signs, and rate of onset of clinical signs. RESULT: 33 (43%) dogs had areas of hyperintensity of the spinal cord greater than or equal to the length of the L2 vertebral body on T2-weighted magnetic resonance images. All 44 dogs without areas of hyperintensity on T2-weighted images had a successful outcome, but only 18 of the 33 (55%) dogs with an area of hyperintensity did. Only 5 of 16 dogs with an area of hyperintensity that had also lost deep pain perception had a successful outcome. The odds ratio for an unsuccessful outcome for a dog with an area of hyperintensity (29.87) was higher than the odds ratio for a dog that had lost deep pain perception (5.24). Duration and rate of onset of clinical signs were not associated with clinical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggest that results of magnetic resonance imaging can be used to predict clinical outcome in dogs with paraplegia caused by intervertebral disk extrusion.  相似文献   

14.
OBJECTIVE: To assess risk factors for recurrence of clinical signs associated with thoracolumbar intervertebral disk disease (IVDD) in dogs that had decompressive laminectomy without attempted prophylactic treatment of other disk spaces. DESIGN: Retrospective study. ANIMALS: 229 dogs. PROCEDURE: Medical records of dogs that had decompressive laminectomy without prophylactic fenestration for a first episode of IVDD and were available for follow-up were reviewed. Information on 7 clinical and 8 radiographic potential risk factors were recorded. RESULTS: Clinical signs associated with recurrence of IVDD developed in 44 (19.2%) dogs. Ninety-six percent of recurrences developed within 3 years after surgery. Recurrence developed in 25% of Dachshunds and 15% of dogs of other breeds combined. Number of opacified disks was a significant risk factor for recurrence. Risk increased with number of opacified disks in an almost linear manner; each opacified disk increased risk by 1.4 times. Dogs with 5 or 6 opacified disks at the time of first surgery had a recurrence rate of 50%. CONCLUSIONS AND CLINICAL RELEVANCE: When all likely episodes of recurrence are considered and a long follow-up period is achieved, true rate of recurrence of IVDD appears to be higher than in many previous reports. Dogs with multiple opacified disks at the time of first surgery should be considered a high-risk subpopulation.  相似文献   

15.
OBJECTIVES: To develop and compare the reliability of 2 methods of scoring pelvic limb gait in dogs recovering from thoracolumbar spinal cord injuries and to use this scoring system to determine the rate and level of functional recovery of dogs with acute thoracolumbar intervertebral disk herniations. ANIMALS: 46 dogs with spinal cord injuries resulting from intervertebral disk herniations. PROCEDURE: Dogs' gaits were videotaped at different time intervals after injury. In phase 1 of the study, the stages of recovery of pelvic limb function were identified, and a numeric scoring system was devised to reflect that recovery. In phase 2, pelvic limb gait was scored by different observers, using a numeric and a visual analog scale. Intra- and interobserver coefficients of variability of both methods were compared. In phase 3, pelvic limb function was scored, using the numeric scale at various intervals after acute thoracolumbar disk herniations. RESULTS: The numeric scale was significantly more reliable than the visual analog scale when both intra- and interobserver coefficients of variability were evaluated. Dogs that were paraplegic with no deep pain sensation recovered at different rates during the first 3 months, whereas dogs that were paraplegic with deep pain sensation typically recovered within 1 month of injury. CONCLUSIONS: Pelvic limb gait of dogs recovering from thoracolumbar spinal cord injuries can be reliably quantified, using a numeric scale. This scale will facilitate the performance of clinical trials aimed at improving the outcome of acute spinal cord injuries.  相似文献   

16.
OBJECTIVE: To determine outcome of and complications associated with prophylactic percutaneous laser disk ablation in dogs with thoracolumbar disk disease. DESIGN: Retrospective study. ANIMALS: 277 dogs. PROCEDURE: Medical records of dogs with a history of thoracolumbar disk disease in which the 7 intervertebral disks from T10-11 through L3-4 were ablated with a holmium-yttrium-aluminum-garnet laser inserted through percutaneously placed needles were reviewed. Complications and episodes of a recurrence of neurologic signs (eg, paresis or paralysis) were recorded. Owners were contacted by telephone for follow-up information. RESULTS: Nine of 262 (3.4%) dogs for which follow-up information was available had a recurrence of paresis or paralysis. Follow-up time ranged from 1 to 85 months (mean, 15 months); signs recurred between 3 and 52 months (mean, 15.1 months) after laser disk ablation. Acute complications occurred in 5 dogs and included mild pneumothorax in 1 dog, an abscess at a needle insertion site in 1 dog, and proprioceptive deficits in 3 dogs, 1 of which required hemilaminectomy within 1 week because of progression and severity of neurologic signs. One dog developed diskospondylitis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that prophylactic percutaneous laser disk ablation is associated with few complications and may reduce the risk of recurrence of signs of intervertebral disk disease in dogs.  相似文献   

17.
OBJECTIVE: To quantify the association between intervertebral disk calcification and disk herniation in Dachshunds. DESIGN: Longitudinal study. ANIMALS: 61 Dachshunds that had been radiographically screened for calcification of intervertebral disks at 2 years of age in other studies. Thirty-seven of the dogs had survived to the time of the present study and were > or = 8 years of age; 24 others had not survived. PROCEDURES: Radiographic examination of 36 surviving dogs was performed, and information on occurrence of disk calcification at 2 years of age were obtained from records of all 61 Dachshunds. Information on occurrence of disk herniation between 2 and 8 years of age was obtained from owners via questionnaire. Associations between numbers of calcified disks and disk herniation were analyzed via maximum likelihood logistic regression. RESULTS: Disk calcification at 2 years of age was a significant predictor of clinical disk herniation (odds ratio per calcified disk, 1.42; 95% confidence interval, 1.19 to 1.81). Number of calcified disks in the full vertebral column was a better predictor than number of calcified disks between vertebrae T10 and L3. Numbers of calcified disks at > or = 8 years of age and at 2 years of age were significantly correlated. CONCLUSIONS AND CLINICAL RELEVANCE: Number of calcified disks at 2 years of age was a good predictor of clinical disk herniation in Dachshunds. Because of the high heritability of disk calcification, it is possible that an effective reduction in occurrence of severe disk herniation in Dachshunds could be obtained by selective breeding against high numbers of calcified disks at 2 years of age.  相似文献   

18.
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19.
The accuracy of survey radiographs in the diagnosis of acute thoracolumbar disc disease in 36 Dachshunds was determined by comparison with lumbar myelographic findings using iohexol. The value of making radiographs immediately after injection of contrast medium and the effectiveness of oblique radiographs in determining the exact circumferential distribution of extruding or protruding disc material were assessed. The presence of a double contrast medium column, resistance to injection and the presence of cerebrospinal fluid flow during needle placement was also evaluated. The location of the affected disc was accurately determined on survey radiographs in only 26 dogs. The myelographic technique used in this study resulted in the correct intervertebral space being identified, together with the exact circumferential distribution of disc material, in 35 dogs. Survey radiographs alone are inadequate for localization of protruding or extruding disc material.  相似文献   

20.
OBJECTIVE: To determine the prevalence of urinary tract infections (UTI), factors that correlate positively with UTI, and whether identified UTI are most likely community- or hospital acquired in dogs with surgically treated type 1 thoracolumbar intervertebral disc (IVD) extrusions. STUDY DESIGN: Prospective cross-sectional clinical study. SAMPLE POPULATION: Dogs (n=92) that were surgically treated for a thoracolumbar extradural compressive spinal cord lesion that was consistent with type 1 IVD extrusion. METHODS: Dogs were evaluated for bacterial lower UTI when possible by cystocentesis and urine culture before surgery, and 48-72, 96-120 hours, and 7 days after surgery while hospitalized. Paraparesis, confirmation of thoracolumbar extruded nucleus pulposus, and informed owner consent were required for study inclusion. Urine specimens (n=297) were cultured and both objective and subjective clinical data were obtained. RESULTS: Prevalence of UTI in dogs with surgically treated type 1 thoracolumbar IVD extrusion was 27% (25 dogs). Temporal prevalence of UTI was 15% (13/89) before surgery, 12% (11/91) at 2-3 days, 16% (12/76) at 4-5 days, and 20% (8/41) at 7 days after surgery. Statistically significant factors affecting UTI prevalence included neurologic and urinary status, sex, administration of perioperative antibiotics, and amount of time body temperature was <35 degrees C during anesthesia. CONCLUSION: UTI are common in dogs with surgically treated type 1 thoracolumbar IVD extrusion. Females, dogs that cannot ambulate or voluntarily urinate, dogs not administered perioperative cefazolin, and dogs whose body temperature falls <35 degrees C during anesthesia have a higher incidence of UTI. CLINICAL RELEVANCE: All dogs with surgically treated type 1 thoracolumbar IVD extrusion should be monitored for the presence of UTI; however, close attention should be paid to females and dogs that cannot ambulate or voluntarily urinate.  相似文献   

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